Provider Demographics
NPI:1295094480
Name:DUSHAJ, AZEM (MD)
Entity type:Individual
Prefix:DR
First Name:AZEM
Middle Name:
Last Name:DUSHAJ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:243 ELM STREET
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:NH
Mailing Address - Zip Code:03743-2099
Mailing Address - Country:US
Mailing Address - Phone:603-543-6940
Mailing Address - Fax:603-543-6950
Practice Address - Street 1:241 ELM ST
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:NH
Practice Address - Zip Code:03743-2009
Practice Address - Country:US
Practice Address - Phone:603-543-6900
Practice Address - Fax:603-542-9497
Is Sole Proprietor?:No
Enumeration Date:2012-05-09
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH16902207R00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHT400230687OtherMEDICARE
NH3101233Medicaid